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Nikki Scott – The FOOF Fixer: Right. Everyone, welcome. I think we are expecting a few more people, but we’re gonna crack on. So tonight’s session—I’m gonna press record before I start saying any more because I always forget this bit.
Tonight’s session is being recorded.
Nikki Scott – The FOOF Fixer: There we go! Um, so welcome, everyone. Lovely to see you, and great that you could join us live.
The replay will be available for you to catch up on. So if there’s any little gems in there that you forget, or that you want to go back to, then I will share the replay in the Facebook group. There’s the words I needed.
Nikki Scott – The FOOF Fixer: This session today is with Sam. Sam is one of the senior trainers on the UGO Hypopressive team. She’s got a wealth of knowledge. I’ll let her do her proper introduction when we switch over.
But Sam’s going to lead the session, talking about diastasis and her campaign to get a postnatal check for every newly postnatal woman.
Nikki Scott – The FOOF Fixer: Let me just switch over.
And then, Sam—
Nikki Scott – The FOOF Fixer: No, that’s not it.
Total technified.
Close to what?
I’m just switching over to Sam.
Sam Blakey: Yeah, I’m here.
Nikki Scott – The FOOF Fixer: You’re here, brilliant.
Sam Blakey: Yeah.
Nikki Scott – The FOOF Fixer: Great.
Sam Blakey: Okay. Well, it’s really nice of Nikki to have asked me to come and do this—something, as she said, I’m really passionate about. I’ve been a women’s health coach, women’s health specialist, for about 10 years now. I used to be a journalist, but I was living overseas in Singapore, and I decided that it was a bit difficult to work as a journalist over there.
I’ve always loved running, and I’ve run 8 marathons. And I love sport—I was always going to be a PE teacher if I hadn’t have been a journalist. So I thought, why don’t I just do what I always wanted to do when I was a kid?
So I trained as a personal trainer and then a Pilates instructor—good to see a reformer in the background there, Lorraine! I’m not that trained—I’m a matwork Pilates instructor. But I brought it in because I felt that I was working more and more with mums, postnatal mums, and being a PT wasn’t enough. I needed to have something that would help me help them recover, and I needed better knowledge.
Sam Blakey: So I did a pre and postnatal qualification and then decided to train as a matwork Pilates teacher. I had never even done one Pilates class in my life, but it seemed like a good idea at the time, and that’s become the bulk of my business.
And then I felt there was a gap—if you’ll excuse the pun—in my training, that I couldn’t quite fix mums who had abdominal separations.
Sam Blakey: So I did a pre and postnatal qualifications, and then decided to train as a matwork Pilates teacher. I had never even done one Pilates class in my life, but it seemed like a good idea at the time, and that’s become the bulk of my business. And then I felt there was a gap—if you’ll excuse the pun—in my training that I couldn’t quite fix mums who had abdominal separations.
And I started to work—well, I’d been working for some time with a mum who was an ardent runner, and she would not stop, even though she had a bad diastasis, and Pilates just wasn’t cutting it. And then one week I was checking her, and I was saying, “Well, it’s held together—what’s changed?” And she went, “Oh, I’ve been doing Hypopressives off the internet.”
And this is in Singapore. And I went, “What?” Never heard of it, you know. So I went and did my research. I literally got on the next course, I got on a flight home. The next time I saw that Nikki and Richard were doing a course and thought, “Yeah, this is what I need,” because it held my client’s abs together like nothing else had.
Whilst we’ve been trying to do the Pilates, and she was insisting on doing too much heavy pressured stuff, and… So I started to introduce that into my training, and it has become a huge part of what I do and the rehab work that I do now with people.
Sam Blakey: So yeah, big fan of Hypopressives. Rehabbed myself after I had caused myself a prolapse having pushed somebody’s broken down Land Rover Defender into a petrol station where she’d run out of petrol. Didn’t realise it was a Land Rover Defender when I offered to help, as I was paying for my petrol, and all these men were watching, waiting for me to fail.
And my stupid pride wouldn’t let me, and so I gave myself a dual prolapse. I knew I’d done it instantly, used the Hypopressives to repair that, then had a hysterectomy later, about six months later—not related to that. Used the Hypopressives from two and a half weeks because I dared, because I was so familiar with it.
My recovery, even my surgeon said, was much more like keyhole surgery. I’d had a full abdominal incision and everything removed. So for me, Hypopressives is this amazing tool. It transforms my work. It makes me stand out from other people, and I’ve got the medical people taking note. And that’s a big deal. So it’s trying to get that message out there.
And that’s what we’re trying to do with raising awareness about diastasis. And I love that people amongst UK Hypopressives who aren’t fully aware of it are asking those questions as well.
Sam Blakey: So I’m going to try and share my screen. Now, I’m not techie. My daughter usually comes to help me do that. Can I try and undo it, Nikki? Just give me a moment. I think this is right.
Sam Blakey: So hopefully this is the right one. So I’m going to share this. I need to—there’s no sound with it, so I don’t think I need to share—well, I’ll put it on just to be on the safe side. So you should be able to see.
Bethia Hope-Rollins: What diastasis is like.
Sam Blakey: Yeah. Can you see the picture of the diastasis?
Bethia Hope-Rollins: We haven’t.
Sam Blakey: Cool. Okay, so that’s good.
Bethia Hope-Rollins: It’s not crude.
Sam Blakey: Sorry.
Sam Blakey: So what we’ve got here is a good, a good set of abs and a not so good set of abs. Okay, I’m just going to—yeah, I’m just going to mute someone. It’s all right. They’ve gone quiet. So, um…
Sam Blakey: What I want to explain to you briefly is what a diastasis recti is, or an abdominal separation, to use its more common name—more familiar name—and how did I get it, or how did anyone get it?
I discovered mine when I was 14 years postnatal with my fourth child, training to do my postnatal and prenatal courses, and that’s when I discovered I’d got one. Even though I had all the red flags to have one—I’ll explain about that in a minute.
So there’s two very graphic pictures here. One’s rectus abdominis muscles in their correct position, and the one next to that is when you have a separation. Now, I think this is quite a kind picture, because actually, some of the women I’ve worked with, they’ve got even larger separations than that. But it just gives you a very quick visual of what it looks like.
Sam Blakey: So, abdominal separations are very common during and after pregnancy. So it’s when the uterus muscles—the uterus stretches and in the abdomen to accommodate the baby. So with the relaxing that’s in our body to help with the growing uterus, the muscle relaxation, the muscles give way a bit, and then we’re putting them under a lot of pressure there with a growing baby.
And also with carrying on doing our normal stuff. So that can cause the muscles to separate. The muscles will separate anyway to grow the uterus, but they can separate sometimes beyond what we mean them to separate if we overdo stuff.
Sam Blakey: But also there’s a connective tissue issue—that’s really hard to say when you’ve had a glass of wine. So, connective tissue issue means that sometimes some of this is hereditary. So you might find that your, your mother had the same thing that you have inherited, the same kind of connective tissue that she has. And there can be a repetition there. So a more, a greater likelihood of it because of the kind of connective tissue, the fascia that you have.
One study found that up to 60% of women may experience DR during pregnancy or postpartum. And yet we still do not incorporate a check for that in our postnatal medical checks, even though it’s easy to do. You’ll see in a minute just how easy it is to check for it. And then the danger of that is, many women go back to exercise absolutely oblivious. I had run six marathons—no, five marathons before I even knew I had a diastasis.
So somehow, because my muscles were quite strong, I managed to hold it at that two-centimetre separation. But with other women, if they don’t know they’ve got that separation, it can get bigger. And that’s the danger.
Sam Blakey: So I’ve just recently launched this campaign called For Crying Out Loud, which is a campaign for the introduction of diastasis checks as part of postnatal care.
Now at the moment, if you’ve had any clients who’ve recently had a baby, you’ll have heard that you’d have had the conversation about how poor the postnatal checks are currently. And I work with a lot of GPs. So I’m really careful not to criticise them. It’s actually—and I’ve never used the word “poor” in front of them. So language is very important when you’re talking to medics.
But the problem is that the six to eight-week check has become the same check that you do the baby’s first jab since COVID. So that means the mum’s very focused on the baby and the fact that they’re going to have pain and not feel brilliant, etc. And um, also that, um, the doctors are also focused on giving the baby the jabs. So there’s very little physical, if any, check for the mum, for the birth mother. And so nobody’s prioritising it.
The mum’s thinking about the baby, and so is the GP. Quite often now, tellingly, they’re not actually trained to check for it. It’s not part of their training. And I have been to coffee mornings where midwives have been present, and the senior midwife who is there with the trainee midwives has actually asked me to show her trainee midwives, because I’m doing abdominal checks at a mums and tots coffee morning, to show her girls—her nurses—how to do it, because it’s not part of their training.
Sam Blakey: So my campaign is hopefully designed to try and encourage NICE and the medical colleges to bring in these checks. Why? Because, frankly, as this quote says:
Mothers are not a niche. They literally make all the people.
I love that quote. It’s slightly paraphrased, but, but we do make all the people. And yet the aftercare or the care postnatally, to recover from having a baby is often quite poor. I mean, Nikki, you had twins, so you know how much it takes a toll on the bodies. On the body.
So it’s kind of just trying to get the medical profession, particularly those that set the standards like NICE and the medical colleges, to recognise a simple test could make such a difference.
Sam Blakey: So the campaign is called For Crying Out Loud, and it’s a campaign for progressive postnatal care. So it’s not a criticism of the current—although it is—I don’t word it as such. And the idea is to just get these checks introduced so that women are aware of it. And then the plan is to build on that into postnatal care beyond that, because actually, we stay postnatal forever.
We’re always going to have a different body than we had before. And there are problems with that. So it’s to work with things like women’s reproductive problems. So many women have problems reproductively with their reproductive organs after giving birth, and when they finish giving birth, and they’re still waiting years for medical intervention for that. And I know that from personal experience.
Sam Blakey: So we’re looking for a greater emphasis on pre and postnatal training at medical school to extend aftercare—this is key, I think—beyond six to twelve weeks and into the first year so that postnatal depression and other medical issues resulting from giving birth can be picked up earlier, such as endometriosis.
Make examinations for abdominal separation a prescribed part of the six-week recheck. So again, as I said, for GPs and midwives to be comprehensively trained in how to conduct this simple test. But then to have a clear rehabilitation pathway to women who are found to have separated muscles.
Because I believe the reason why the NHS is not looking at this problem at the moment is because they have no pathway. So we need to have—scary thought—but probably better controls in the fitness industry so that the NHS can confidently refer out, because the NHS can’t meet the demand anymore.
Sam Blakey: So there has to be people registered within, outside the NHS, but who have been passed by the NHS as being competent. Because the other thing is, I’m sure you’ll all agree that not all certification that you need to work as a personal trainer or anything in that area is necessarily well policed.
So some of it—you can do a course in a weekend and claim you’re a postnatal, prenatal specialist. So we need some controls on that. But I’m utterly convinced, from the evidence I’ve seen, that bringing in this simple check and extending postnatal care into the first year will eventually pay dividends in the long term and save the NHS money. And I don’t think many can argue with that when you’ve got women having surgeries for prolapse, and you have the meshing scandal. You can see how, had they been fixed—had they been identified to have a problem earlier on—then that might not have been such an issue as it was.
Sam Blakey: So what’s the lowdown on abdominal separation? What are the symptoms? So I’m going to go into this a little bit more in a moment. I’m very aware of the time, so I won’t go on too long.
But you can see you have a separation if you look at your belly. It’s an external visual as well because your skin will be slack. There will be no tension there, and it sits funny sometimes. Even in the worst cases, you can actually see the separation. Okay.
You’ll suffer from backache. You’ll have no core strength, so your back, yours—you will suffer. Poor posture. So again, all these things I keep on thinking, “Oh, Hypopressives will sort that out.”
Pain. Okay. They get pain. If you’ve got an abdominal separation, you will have back pain. You will have all kinds of pain going on in the abdominal area. And bladder issues. So you will—may have, when you sneeze or cough—you may have incontinence issues.
Sam Blakey: And the longer term risk is a prolapse. And of course, we know that Hypopressives can fix the grade two, even grade three. Grade four, grade five can be a lot longer programme for them, but also sometimes only surgical intervention will finally make the difference.
But we can get in early, get Hypopressives working, and I’ve seen some amazing results, which I’ll touch on later.
Sam Blakey: So how big is the diastasis? How do we measure it? So we usually measure it by finger width. So I’m going to look like I’m sticking my two fingers up at you. But, um, so one finger is a centimetre. Okay. Two fingers—two centimetres. Three fingers, etc., okay? And we do it widthways.
So we measure down—here, I’ll show you a bit better later—but we measure down like that. So separation of two to three centimetres is outside—it’s not really in the panic zone. It’s very fixable, but it needs fixing. So a low-pressure regular exercise system, like Hypopressives, that doesn’t overload the rectus abdominis or the pelvic floor.
Because the problem we’ve got is, everybody thinks, “Oh, if my muscles aren’t working properly, I need to do some crunches, some push-ups—sorry, some planks, some sit-ups.” Those three things are the worst things you could do if your abs are not working properly. Okay.
Sam Blakey: So they’ll put the rectus abdominis under immense pressure. Because as soon as you bring pressure in—you’ve got that sitting in your abdominal cavity—where’s it going to go out? It’s going to leak out of the weakest point. And your weakest point will be your pelvic floor—hence the prolapse. Or your rectus abdominis—hence the growing separation.
Okay, so think of a balloon with a hole in it. The minute you press around the hole, the hole gets bigger until it bursts. The balloon bursts. And so that’s the kind of thing that’s going on.
Now, here we have a problem straight away, because half of the cases, the mum’s already got toddlers. Okay. So she’s already lifting a load. Then you go and pick up a car seat. It weighs a freaking ton before you even put the baby in. I want the manufacturers to make it out of carbon fibre, because carbon fibre is so light. We know it’s safe because they make aeroplanes and cars out of it.
Sam Blakey: But it’s expensive. And unfortunately, nobody’s kind of thought of it or decided it’s practical. There’s plenty of waste from carbon fibre that they could use to make car seats.
So you’ve got a mum who’s got a diastasis. And I say to them, “Can’t lift heavy.” They go, “Well, how am I going to get my baby into the car?” And then they walk in with Brutus sitting in a car seat, you know, he weighs a freaking ton. Her husband is six foot six and a wrestler, you know. And so she’s got this great big baby.
She’s a little lady, so she’s got the diastasis because she had a big baby and she has a small frame, and she’s lugging this. And I have my goddaughter—I’ve been helping her recover. And she has a six-foot-five partner who’s built like a wrestler. And she’s five foot two.
Sam Blakey: And really petite. And her baby son and now her baby daughter look like mini wrestlers. And that’s what she’s carrying. And that’s what she was carrying around before she had them. And that’s what she’s carrying around now in a car seat, or picking up and taking in and out of the bath, the toddler.
So it’s a work in progress with her, because every time we do quite well with the Hypopressives, then she goes and does something mad. But the Hypopressives is kind of holding her in place. It’s holding that closure.
Sam Blakey: So those are the issues. I’ve gone off a bit. A four to five finger plus separation is considered severe, okay? And in these cases, the connective tissue is stretched and the core muscles are no longer able to provide the support that you need in the pelvic and abdominal region. So that’s quite serious.
In Singapore, before I had Hypopressives, I knew of two of my clients who had to go in for surgical repair, okay? Now, even with Hypopressives, that would have been a long programme. And when I’ve worked with people who are five, four centimetres separated, sometimes we only get to two centimetres.
And that’s their closure because of the damage that was done. But what is imperative and really important is the fascia, the connective tissue underneath, is right up to that separation, which gives them the best possible chance of maintaining that closure so that they wouldn’t ever tear or reopen.
Sam Blakey: So what I love about Hypopressives is, it’s not a superficial closure which crunches and everything gives you, which is, if you’re lucky, they might close it up a little bit, but they will not have activated the fascia underneath at all. And more often than not, they will have probably made the closure—or the opening—worse.
So what Hypopressives does is get to the nitty gritty, and it gets that fascia, that tissue, that connective tissue back up before you close. That’s imperative. What you don’t want is a superficial closure with no tissue underneath to support it, okay?
Sam Blakey: So, this lady—I hope you can see her. Week one, look at her. For me, the most important thing about this is posture. Exclusively Hypopressives, this client. So she was four children in seven years.
And the reason I started my campaign was the first week I saw her, I saw another lady with a prolapse who was sixty-one, four children in seven years, but had obviously had the diastasis for twenty-nine years because her youngest son was twenty-nine. She had a five-finger separation. So both these women had five-finger separations.
And what it told me was that in thirty years, the checks hadn’t improved because this lady was a year postnatal and had never been picked up, and neither had the lady who was sixty-one—or fifty-nine, I can’t remember her exact age—and both were presenting with the same thing.
Sam Blakey: So my argument is, in thirty years, we’ve cured some cancers. We’ve got cures for other things, and that’s fabulous. But we’ve still got the same shitty—sorry, there’s no other word for it—care for these women, who are not niche. They literally make all the people.
And I’ve got five kids. Thank God I didn’t give birth to the fifth one, because I think I wouldn’t have survived it. But I gave birth to four kids—very, very nasty, long labours. And, you know, we need looking after because we keep on adding that need to the population. Otherwise, there would be no people.
Sam Blakey: So look at the difference on week eleven—just week eleven. Now, she said Hypopressives made her focus on what was going in her mouth as well, so there’s a little bit of being careful about what she’s eating. But look at that waistline, and look at her posture.
Because for me, it’s the posture. She hated herself when she came to see me. Her body had let her down. She felt like she was a shadow of the woman that she was when she first started having her babies, and she had lost all… She was depressed, and she had lost all the love of herself. She didn’t—she lost herself.
By week eleven, the difference in her whole personality, her whole persona, was massive. And what I love about this picture is, it shows her mental health, her mindset, in the way she’s standing, because she’s proud.
Sam Blakey: And ten weeks later, I went to—I was invited to her fortieth birthday party, and she was rocking it in this silver, dazzly, glittery dress—mini dress—and she danced the night away.
And she said to me, she whispered in my ear, “Couldn’t even have dreamt of doing this. I’d have bloody weed myself, if you’ll excuse my language.” So I thought, yeah, this is great.
And I’ll come to the—yeah. So it is the regular practice, as I’ve said here, that is the key to success. And it’s the hardest bit. I know when these women come to see me that I can help them, but they have to help themselves.
And sometimes that—they want a pill. They want a magic wand. And so that is where the stories aren’t successful, is where they just won’t do the homework. So it’s about the practice.
Sam Blakey: And this lady is still doing it today. She pings me: “I’m just keeping it up,” she goes, even though actually she’s closed really nicely. She’s got that little two-finger gap, but it’s really well supported. But she’s not taking any chances. And I love her commitment. So she sends me a thumbs up every day she’s done one.
Sam Blakey: So the red flags. I’ve already mentioned those—lots of babies close together. Twins—I’ve mentioned Nikki, so twins. You know, several babies in a relatively short span, so like those two ladies I’ve just talked about.
A large baby. I lived in Singapore. You would not believe the number of huge New Zealand rugby players who ended up marrying a tiny Singaporean lady, and then they’d have these huge babies. So I literally broke my—my experience on these tiny ladies who were having—you know, they were like five foot, five foot one, and they were having these nine-and-a-half-pound babies, carrying these nine-and-a-half-pound babies.
Sam Blakey: So I had so many diastasis, it was difficult to know where to start. So that was a great baptism of fire for me—not so great for them—but a wonderful way for me to hone my art.
And a traumatic birth. I think that’s probably why I had one because I’m not a small lady, but I did have big babies. But I spent thirteen hours giving birth to them at a time, and so I had long, drawn-out labours, and that pressure as you’re pushing to get the baby out can put real pressure on the pelvic floor—a huge amount of belly pressure—and separate those muscles further.
And then, of course, you can also—it can also be an after-pregnancy, not just during, because of the way the uterus stretches the muscles. Okay?
Sam Blakey: And one study found—this is what I find really incredible—sixty percent of women may experience a DR during pregnancy or postpartum. Okay?
And although it’s an easy check, GPs are not trained to do it, neither are midwives. In fact, very quickly, I’ll tell you a story that really shocked me. One of my best friends here is a midwife, and she—we’ve worked together, I’ve shown her how it works. She’s a big Hypopressive fan. And she brought diastasis checks in because I showed her how to do them, and she’s now a senior midwife, and she trains student midwives.
And then one of the student midwives went to the senior senior midwife and said, “Why is Rachel showing me this test? Because we’re not taught it in college.”
Sam Blakey: And so the senior senior midwife went back and said, “It complicates things. Don’t do it anymore.”
So she was told she couldn’t teach it to her trainee midwives anymore, even though they know they should be. Because it complicates things, because they don’t have an avenue of what to do if they find they have them.
So this is—this is an issue that we’re fighting at the moment.
Sam Blakey: So what are the signs and symptoms? I mentioned about the tummy. You can have a bulge or a pooch or just a tummy. It could be above or below the belly button or all over. People tend to feel they’ve got like a bit of, like, a shelf, particularly, like, if you’ve had an abdominal incision. You can have a bit of a shelf, but if you haven’t had one, you can feel like you’ve got one when you’ve had a vaginal delivery.
You can have a ridge down the centre of the belly. So in the worst cases, you’ll actually be able to visually see it rather than just have to feel for it.
And a soft, jelly-like belly. So a lot of women—mums—will come to me and go, “I just can’t get rid of my belly,” and it’s—nine times out of ten—it’s a diastasis. It’s not diet or anything.
Sam Blakey: Doming or coning is one of the easiest ways to see it. But to do that, you have to do a sit-up or a crunch, and you don’t want to encourage them to do that.
Difficulty lifting heavy objects—that they feel it makes them feel very heavy—and doing the everyday tasks. So all the things we have to do as a parent.
Low back pain because you’ve got, as I said, little abdominal support and poor posture.
Crucially, pain during sex. Now that’s a bit of a bummer, isn’t it? After you’ve had a baby, you don’t really want that. So that’s a downside to it. And hip or pelvic pain. So that’s the other kind of pain from the pain I was mentioning earlier about the back pain.
Bladder issues—I mentioned them briefly—leaking when sneezing or coughing. Constipation is the other end of that scale.
Sam Blakey: Because again, you’ve got no strength to work with that and no core strength. And of course, as I mentioned with that lady whose pictures you saw, the mental health toll on people when they feel their body is no longer working as it should do, mixed in with postnatal depression as well. The risks of that.
What to avoid under all circumstances? Jumping on the trampoline with the kids. This is my pet hate, okay? It is the worst thing you can do, okay? Because when you jump up and then jump down, you’re going into a lowered surface, and your poor pelvic floor, which isn’t functioning very well anyway, is going up and then down with no control.
Sam Blakey: So I had a client—we’d nearly closed her—in Singapore, and she went on a children’s trampoline at a party, and she tore. And she ended up having to have surgery because once they tear, it has to be surgical because there’s no connective tissue, it’s gone. It needs to be repaired because the connection’s gone, and that’s a much bigger rehab after that.
So yeah, not a big fan of kids’ trampolines. Stay off them. Lots of mums go to me, “Well, I can’t go on one anyway because I leak.” So then I’m going, “You need to come and see me because you need Hypopressives.”
Sam Blakey: Avoid any exercises that forcefully contract the rectus abdominis against gravity. So that means sit-ups, the crunches—we’ve already talked about them—full planks, weights. Heavy weights. Because again, the first place you’re going to put pressure on when you’re lifting heavy weights is down onto the pelvic floor.
High impact—running, jumping, etc. I had a client who was a triathlete. Hates yoga, hates Pilates. Physio in the hospital here, but knew she had this—she’d had this fourteen, like me, fourteen, thirteen years, I think it was—diastasis recti.
And she came to me in desperation. And I said, “Well, I’m sorry, but if we’re going to work with this with Hypopressives, you’ve got to give me a chance. You’ve got to stop doing your running.”
Sam Blakey: “And you can keep doing swimming, but you can’t do breaststroke.” I’ll explain about that later. But here I can bring it in. So breaststroke is not good. Breaststroke separates the abs. So if you’ve got a separation, everyone thinks breaststroke is the safe stroke. But when you’ve got a separation, all you’re doing when you do that [Sam imitates breaststroke motion] is separating the abs further.
I didn’t know that until a physio told me that, and then it all made sense. Do this [Sam mimics freestyle motion] as long as you’re not holding your breath for too long and you’re drawing the muscles up together, okay? So if you’re going to swim, it’s overhead, not breaststroke.
But so I stopped her doing her running. We got really good results. She was doing it twice a day because she just wanted to get it done. And then I said to her, “You’re holding back a bit. I think you need to stop your swimming now.”
Sam Blakey: So she was just doing her cycling. And we knocked it on the head. Eight weeks it took her to do that, after fourteen years. And she now comes on to—if I want to do a webinar, she’ll come on as a physio, saying that she’s been through it. So it really helps to reinforce what we’re saying when another medic professional comes on—or a medic professional rather, because I’m not—but another professional comes on and supports what you’ve done through personal experience.
Lifting children—that’s the other big thing not to do when you’ve got a diastasis. And unfortunately, it’s impossible because nine times out of ten, you’ve got kids. But that is also not great. So I always say to my clients, “Do not lift your toddlers out of the bath. Help them get out,” because that’s one of the most vulnerable points.
When you’re bending over the bath to pick up a child—or get your partner to help. If it’s a baby, it’s not quite so bad, but it’s things like that in everyday living.
Sam Blakey: So how do we check for a diastasis recti? So I use this machine. [Sam holds up a Pilates circle.] It’s wonderful. Lorraine, you know what this is. I love a circle.
I saw a joke yesterday. Father Christmas was with this little girl, and he said, “What do you want for Christmas?” And she says, “I want a real dragon.” And he says, “Oh, come on, be realistic. Give me something realistic.” And she said, “I wish my Pilates teacher wouldn’t use the circle anymore.” And he goes, “Okay, what colour do you want that dragon to be?”
And I thought, yeah, that sums it up perfectly.
Sam Blakey: So circle—here, under the head—protects your neck or your client’s neck when you want to check. You get them to lift up fractionally, so they’re in control the whole time because we need to see a contracted ab to give us a good measure. But we don’t want them to do a crunch. So I call this a head lift, okay?
So they’re lying on the floor in the position that lady is in, but they have the circle. You can use a towel if you haven’t got a circle, but this is like—my one’s more expensive because it’s body control—but you can buy these on Amazon for £9.99, £10.99. They don’t have to be a great quality just to lift your client’s head off the floor.
Sam Blakey: So you get them to lift up and to breathe normally up here—not hold their breath—so they’ve only lifted to their lap muscles, so roughly to the bra line. And they can come down at any time. And you start feeling, but remember to give them a break because they do potentially have a diastasis.
You start feeling at the top here—so here. You start at the sternum because some people go all the way up. And you can feel a gap. There’s a separation. If there’s a separation, you can feel the muscle walls, and you measure it with your fingers going down like that—or like that, hopefully not. And then you carry on.
So let them rest for a bit, bring them back up again and go further down. So we’re feeling above the belly button. And then you can feel on the belly button.
Sam Blakey: Now, the belly button is your weakest point. It’s where the umbilicus is attached to the baby, so it’s very much our weakest point. And nine times out of ten, that’s where the widest thing is, unless somebody’s had a little bit of a tear. But sometimes, occasionally, you will see something that doesn’t follow the rules. And that’s fine.
It’s not fine, but you can deal with it still. And so it tends to be bigger around the belly button. Relax again.
What you’ll want to see is some sort of abdominal activation. If they’ve got no activation, you carry on all the way down to the groin, okay? And what you’ll find is the picture is a diamond shape because it’s always bigger around that middle area and then narrower at the other bits. Okay? That’s the normal conformity. But not everybody conforms, of course.
Sam Blakey: And keep letting them come down so they’re not over-stressing, because you don’t want to make the symptoms worse.
And then you need to know the depth. So the depth is by knuckle or nail. So some people—they’re really lucky—I can barely get the top of my fingernail in before I meet tissue. So when they’re up in that position, you want to feel something against the tip of your finger. Sadly, some people can go down to the second knuckle, so that means they’ve got a gap—a depth of nearly my whole finger, okay?
And I usually use my index finger and my middle finger. So it’s really useful to have those measures because you can see progress as well.
Sam Blakey: So I always take pictures of their posture—of them standing—because that’s also one of the biggest visuals that you can see changing. And also I take pictures of the—I tell them to take pictures of themselves in the mirror with their bellies, you know, in their underwear, or get their partner to do it.
So they have, which is what that other client did, so they have these visuals because nothing speaks more than a picture. Okay? And if I take pictures of them, I then send them to them, and in front of them, I delete them and ask them to keep the pictures themselves so we can see the progress. And that protects their privacy as well, obviously.
Sam Blakey: So when you’ve done that, you’ve ascertained how deep and how wide it is, then you’ve got something to work with. And then they can physically see the improvements. And nothing speaks clearer of how brilliant Hypopressives is when taught correctly and done correctly—practised correctly—than change. Physical change that they can see.
So I always say to them, “Do you want to have a quick feel?” So they know I’m not talking now—I’m not talking this up. And I let them have a little feel themselves, so they can see that this is exactly where we are. So that transparency is really important.
Sam Blakey: So we’ll have a go at the end with that if you want to. So I’ve explained all of that, um, so that’s—I’m not going to go over that again because I think we’ve covered it all.
Um, so yeah, here we go. This is what we need to do. So remember, when you check for a diastasis, you’re looking for both the width and the depth. The width tells you how far apart the muscle walls are. The depth tells you the state of the connective tissue.
Okay, so that’s a big one for me because it’s not just about closing the gap. I’ve said this before, but a superficial closure—where you’ve done planks, sit-ups, crunches, and you’ve forced it to close without addressing the fascia—can mean it reopens easily. Or it’s fragile and can tear again because you’ve got no support there. And that’s why Hypopressives is so amazing, because it targets the fascia.
Sam Blakey: So my campaign—um, I’ve just put this in. You know, it’s designed to push for these changes and bring awareness. So, this is what I would ask you all to do if you want to get involved with it.
You can follow it on social media. I’m trying to raise awareness. I’m also trying to collect data, so anybody who’s happy to do some checks and send me anonymous stats—that’s what I’m after—so I can start to build up some research because there’s not a lot of research in the UK, and the medical profession love data, don’t they? So we need to give them data to look at.
If you’ve got any GP friends or midwife friends, then I’d love you to get them to follow the campaign or get them to take an interest in it because, really, I need the medical people to help us get this message out there.
Sam Blakey: And I’m happy to talk to anyone about it. And like I said, I’m hoping this will be something that in time will actually be introduced as part of the standard six-week check. Because when I talk to GPs, they say, “Yeah, you know, we’ve got a lot to do. We’re trying to do everything.” And I say to them, “It literally takes under two minutes.”
It’s a two-minute check, and it can make such a massive difference. And if you give that mum a rehab pathway, we could save so much NHS money in the future because we’re preventing surgery.
We’re preventing prolapse. We’re preventing all the other things that come from ignoring it, including mental health problems. Because when women don’t feel like their bodies are working properly, it’s so damaging to their confidence and their mental health.
Sam Blakey: So that’s what the campaign’s all about. And, um, yeah, I hope you’ll all get on board with it. I know a few of you have already started sharing it on social media, so thank you for that.
Right, so what I want to do now is get you all to check yourselves. So if you’re up for it—let’s do it now. I’ll just stop the share so I can see you all.
Nikki Scott – The FOOF Fixer: Brilliant, Sam, that was so good. I know you’re going to get everyone to check in a minute, but I just want to say how brilliant that is. Like, the way you explain everything—it’s so clear. And the stories as well, like the case studies you use, it really helps to bring it home.
Sam Blakey: Oh, thank you, Nikki. I think the stories are so important because people relate to them, don’t they? And I always think when you can show someone a real example of someone who’s been through it and come out the other side, it gives people hope, doesn’t it?
Nikki Scott – The FOOF Fixer: Definitely. And the pictures as well—the before and afters. Like, I know you said posture is such a big thing, but you can really see it in those pictures. It’s amazing.
Sam Blakey: Yeah, exactly. And it’s not just about aesthetics, is it? It’s about feeling strong and confident in your body again. That’s what I love about Hypopressives—it gives people that back.
Nikki Scott – The FOOF Fixer: Yeah, totally agree. Right, so who’s up for checking their diastasis now?
Sam Blakey: Okay, let’s do it! So grab a mat or find a space on the floor. If you haven’t got a Pilates circle, don’t worry—you can use a rolled-up towel or even just support your head with your hands.
Sam Blakey: Okay, so what I want you to do is lie down on the floor, knees bent, feet flat on the floor. Make sure your head is supported—either with a rolled-up towel or your hands if you haven’t got a circle. And just relax your shoulders down.
Now, I want you to take a nice deep breath in, and then as you breathe out, just gently lift your head a fraction off the floor. Not a crunch—don’t pull yourself up. Just a tiny lift, so you’re engaging your abs. And hold it there.
Sam Blakey: Now, take one hand and use your fingers to feel down the centre of your abdomen, starting just below your sternum. Press gently but firmly into your tummy. You’re feeling for any gap between the muscles.
Move down slowly—take your time—towards your belly button. You’ll probably find it’s a bit softer there, and if there’s a separation, you’ll be able to feel the sides of the muscle wall. Keep breathing normally, don’t hold your breath.
When you reach the belly button, note how wide the gap is—use your fingers to measure it. One finger, two fingers, three fingers. And then gently relax your head back down for a moment.
Sam Blakey: Give yourself a little rest, and then when you’re ready, we’re going to come back up and check below the belly button. So lift your head again, just a tiny lift, and this time start feeling from the belly button down towards the pubic bone. Same thing—feel for a gap, check the width, and note how deep it is.
Remember, you’re checking for two things: the width—how many fingers fit in the gap—and the depth—how far down your fingers can go. If it feels soft and squishy, that’s the connective tissue. Ideally, you want to feel some tension there, but if it’s very soft, that’s a sign the fascia isn’t working properly yet.
Sam Blakey: Okay, so once you’ve done that, just relax and sit yourself up carefully. Now, does anyone want to share what they found? You don’t have to, but sometimes it helps to talk it through.
Nikki Scott – The FOOF Fixer: I’ll go first, Sam. So I can feel about two fingers at my belly button—it’s not too deep, but it’s definitely there. Above the belly button feels okay, but below, it’s maybe one and a half fingers. So I guess that’s not too bad?
Sam Blakey: Yeah, Nikki, that’s actually really common. Most people will have a bit more separation around the belly button because, as I said earlier, that’s the weakest point. And below the belly button, if it’s shallower, that’s a good sign—it means there’s still some tension there.
What you want to focus on now is building that tension back up with Hypopressives. It’s not just about closing the gap—it’s about strengthening the fascia underneath to support that closure.
Nikki Scott – The FOOF Fixer: Brilliant, thank you. That makes so much sense.
Sam Blakey: No problem! So has anyone else had a go? If you’re not sure what you’re feeling, that’s totally normal the first time. It can take a bit of practice to get used to it.
Bethia Hope-Rollins: Yeah, I think I’ve got about three fingers at the belly button, and it’s quite deep. Above and below are a bit better, maybe two fingers. But I didn’t really feel much tension at all—it’s quite soft.
Sam Blakey: Okay, Bethia, thank you for sharing that. So that’s a clear sign the fascia needs some work, and Hypopressives will really help with that. When the connective tissue is very soft, it means there’s no real support yet, so we need to start gently building that back up. The good news is that it’s totally fixable, but it takes consistent practice.
Sam Blakey: And I want to stress this—don’t panic if you’ve got a bigger gap. It’s really common, and it doesn’t mean you’re broken or that you can’t fix it. Hypopressives is so powerful because it targets the connective tissue directly, and as you strengthen that fascia, you’ll start to see and feel real improvements.
Sam Blakey: Anyone else want to share or got any questions?
Nikki Scott – The FOOF Fixer: Yeah, I think that’s really reassuring, Sam. Like you said earlier, it’s not just about closing the gap—it’s about making sure it’s properly supported underneath so it doesn’t reopen.
Sam Blakey: Exactly, Nikki. That’s the key. So many people focus on closing the gap without realising that if the fascia underneath isn’t working properly, it’s only a superficial fix. That’s why Hypopressives is such a game-changer—it works from the inside out, and that’s what makes it so effective.
Sam Blakey: Right, so if you’ve found a gap, don’t panic. It’s just a starting point. Hypopressives will help you get that tension back, and I’m happy to answer any questions or guide you through anything you’re unsure about. If you want to connect with me afterwards, just drop me a message—I’m always happy to help.
Nikki Scott – The FOOF Fixer: Amazing, Sam. That was so, so good—thank you so much. I think everyone’s got so much out of that. And it’s just great to see how passionate you are about this and how much of a difference it’s making.
Sam Blakey: Oh, thank you, Nikki. I really appreciate it. And thank you all for coming tonight—it’s been great to talk to you. And if I can leave you with one thing, it’s this: don’t underestimate the power of what you’re doing. Whether it’s Hypopressives or just spreading awareness about diastasis, every little bit helps. So keep going—you’re all doing amazing work.
Nikki Scott – The FOOF Fixer: Thank you so much, Sam. And thank you to everyone for joining us tonight. I’ll make sure the replay is available in the Facebook group, so if you want to go back and catch anything again, you can. And if you’ve got any questions, just post them in the group or message me, and we’ll make sure you get the answers you need.
Thanks again, everyone. Have a great evening!
Sam Blakey: Bye, everyone!
Nikki Scott – The FOOF Fixer: Bye!
